Colluoglu Tugce, Akın Yeşim
Cardiology, Karabük University, Karabük, TUR.
Cardiology, Karabuk University, Faculty of Medicine, Karabuk, TUR.
Cureus. 2023 Aug 2;15(8):e42846. doi: 10.7759/cureus.42846. eCollection 2023 Aug.
Background Using epicardial adipose tissue thickness (EATt) and neutrophil-to-lymphocyte ratio (NLR) as individual indicators provides beneficial insight into the prognosis of patients suffering from heart failure with preserved ejection fraction (HFpEF). Aim In our study, we aimed to evaluate whether the combined evaluation of NLR and EATt would provide an advantage for identifying high-risk HFpEF patients according to hospitalization for heart failure (HHF) and left ventricular diastolic dysfunction (LVDD). Method A total of 168 outpatients with HFpEF were retrospectively analyzed. The predictive performance of two inflammatory variables was assessed by the receiver operating characteristic curve and a one-way analysis of variance (ANOVA) test. The patients were stratified into three distinct risk categories based on the established cut-off values for EATt and NLR as follows: Group I, high risk; Group II, middle risk; and Group III, low risk. Results Patients in Group I had the highest risk for HHF and the presence of LVDD (p=0.001 for HHF, p=0.011 for LVDD). Patients in Group I also exhibited more symptomatic and a greater number of comorbidities. In Group I, more structural remodeling (enlarged left ventricular end-systolic volume index (LVESVI) and left atrial volume index (LAVI)) and associated signs of increased intracardiac pressure (elevated E/A ratio, medial E/e') were observed. Conclusion The results of our study indicate that the use of both EATt and NLR among patients with HFpEF may provide better accuracy in predicting HHF and LVDD compared to the use of either EATt or NLR alone.
将心外膜脂肪组织厚度（EATt）和中性粒细胞与淋巴细胞比值（NLR）作为个体指标，有助于深入了解射血分数保留的心力衰竭（HFpEF）患者的预后。目的：在我们的研究中，我们旨在评估联合评估NLR和EATt是否能在根据心力衰竭住院（HHF）和左心室舒张功能障碍（LVDD）识别高危HFpEF患者方面具有优势。方法：对168例HFpEF门诊患者进行回顾性分析。通过受试者工作特征曲线和单因素方差分析（ANOVA）测试评估两个炎症变量的预测性能。根据EATt和NLR既定的临界值，将患者分为三个不同的风险类别：第一组，高风险；第二组，中风险；第三组，低风险。结果：第一组患者发生HHF和LVDD的风险最高（HHF的p = 0.001，LVDD的p = 0.011）。第一组患者还表现出更多症状和更多合并症。在第一组中，观察到更多的结构重塑（左心室收缩末期容积指数（LVESVI）和左心房容积指数（LAVI）增大）以及心内压升高的相关体征（E/A比值升高，E/e'中位数升高）。结论：我们的研究结果表明，与单独使用EATt或NLR相比，在HFpEF患者中同时使用EATt和NLR可能在预测HHF和LVDD方面具有更高的准确性。
